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Thread: Prolotherapy

  1. #1
    Join Date
    Apr 2007

    Question Prolotherapy

    AAPC: Back to School
    Our dr. Has a couple of patients that have asked him to do prolotherapy injections on them. Does anyone know of a code to us and if the insurance carriers are paying for this type of a procedure?

  2. #2
    Join Date
    Apr 2007


    M0076 prolotherapy is a HCPCS code that could possibly be used. The commercial carriers should have medical policy on the coverage for this and if this is the HCPCS code they recognize> I did not look to see the ratio of carriers that recognize payment versus ones that do not.

    Below is from NCD from Medicare stating it is non covered

    Indications and Limitations of Coverage

    The medical effectiveness of the above therapies has not been verified by scientifically controlled studies. Accordingly, reimbursement for these modalities should be denied on the ground that they are not reasonable and necessary as required by §1862(a)(1) of the Act.

  3. #3
    Join Date
    Apr 2007


    Thank you! Have a great day

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